*Article* **Adalimumab Therapy Improves Intestinal Dysbiosis in Crohn's Disease**

**Davide Giuseppe Ribaldone 1,\*, Gian Paolo Caviglia 2,\*, Amina Abdulle 2, Rinaldo Pellicano 3, Maria Chiara Ditto 4, Mario Morino 1, Enrico Fusaro 4, Giorgio Maria Saracco 2, Elisabetta Bugianesi 2 and Marco Astegiano 3**


Received: 17 September 2019; Accepted: 8 October 2019; Published: 9 October 2019

**Abstract:** The response to treatment with biologic drugs, in patients with Crohn's disease, could be associated with changes in gu<sup>t</sup> microbiota composition. The aim of our study was to analyse the modification of microbiota during adalimumab therapy in patients with Crohn's disease. We performed a prospective study in patients with Crohn's disease analysing gu<sup>t</sup> microbiota before start of adalimumab therapy (T0) and after six months of therapy (T1). Among the 20 included patients, the phylum *Proteobacteria* fell from 15.7 ± 3.5% at T0 to 10.3 ± 3.4% at T1 (*p* = 0.038). Furthermore, the trend in relation to therapeutic success was analysed. Regarding bacterial phyla, *Proteobacteria* decreased in patients in whom therapeutic success was obtained, passing from a value of 15.8% (± 4.6%) to 6.8 ± 3.1% (*p* = 0.049), while in non-responder patients, percentages did not change (T0 = 15.6 ± 5.7%, T1 = 16.8 ± 7.6%, *p* = 0.890). Regarding the *Lachnospiraceae* family, in patients with normalization of C reactive protein six 6 months of adalimumab therapy, it increased from 16.6 ± 3.1% at T0 to 23.9 ± 2.6% at T1 (*p* = 0.049). In conclusion, in patients who respond to Adalimumab therapy by decreasing inflammation, there is a trend of intestinal eubiosis being restored.

**Keywords:** *Bacteroides ovatus*; *Bifidobacterium adolescentis*; Dysbiosis; *Faecalibacterium prausnitzii*; *Ruminococcus gnavus*
